title: Long-term follow-up in patients with indeterminate Barrett esophagus.
abstract: BACKGROUND
  Barrett esophagus (BE) is a major risk factor for adenocarcinoma of the distal esophagus. Reliable detection of BE during upper endoscopy is therefore mandatory. According to most guidelines, diagnosis of BE requires both endoscopy and histology for confirmation. However, since adenocarcinomas were also described in patients with indeterminate BE, i.e. endoscopic visible columnar metaplasia but no histological confirmation of goblet cells or vice versa, debate has risen on the risk of malignancy and the need for endoscopic surveillance in such patients.
  
  
  METHODS
  The study was aimed to assess long-term follow-up data on 209 patients with indeterminate BE (on histopathology or endoscopy) initially examined between 1999 and 2000. Patients or referring physicians were contacted concerning the most recent endoscopic and histopathological results.
  
  
  RESULTS
  Follow-up data could be assessed in 149/209 patients (65.1%) after a mean follow-up period of 9.4 years (SD ±2.4 years). Neoplasia was not reported for any patient. The previous endoscopic-histopathological diagnoses could be confirmed in 3 patients only. In the group with endoscopic diagnosis of BE but no histopathological confirmation, BE was described histopathologically in 1 patient during follow-up.
  
  
  CONCLUSIONS
  Persistence of indeterminate BE is poor during long-term follow up. The risk of cancer appears to be negligible. Hence, surveillance of these patients appears equivocal.
authors.affiliation: Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Becker
authors.forename: J
authors.initials: J
authors.lastname: Bobardt
authors.forename: R
authors.initials: R
authors.lastname: Ott
authors.forename: T
authors.initials: T
authors.lastname: Rösch
authors.forename: A
authors.initials: A
authors.lastname: Meining
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D001471:Barrett Esophagus / Q000175:diagnosis / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D011379:Prognosis